Diagnostic Performance of Interferon-Gamma Releasing Assay in HIV-Infected Patients in China |
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Authors: | Yanhua Yu Xiuying Zhao Wen Wang Hao Wu Ming Chen Wenhao Hua Huizhu Wang Ting Wei Yanmei Jiao Guizhen Sun Wei Li |
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Institution: | 1. Department of Clinical Laboratory, Beijing You’an Hospital, Capital Medical University, Beijing, China.; 2. Center for Infectious Diseases, Beijing You’an Hospital, Capital Medical University, Beijing, China.; 3. Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China.; 4. Molecular Virology Group, Queensland Institute of Medical Research, Brisbane, Australia.; Chinese Academy of Medical Sciences, China, |
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Abstract: | BackgroundActive tuberculosis infection represents a very common and significant threat to HIV-infected patients. But measures to accurately detect it are limited.ObjectiveTo compare and analyze the diagnostic efficacy of T-SPOT.TB alone and in combination with TST in HIV-infected patients in China.MethodTST (tuberculin skin test) and T-SPOT.TB were performed on 131 HIV-infected patients admitted in Beijing You’an Hospital and Beijing Ditan Hospital between Oct, 2010 and Jul, 2012, who were initially diagnosed as suspected ATB (active TB). The patients were further categorized into ATB and Not ATB based on clinical and cultural evidences. The performance of TST and T-SPOT.TB were analyzed and compared.ResultsThe sensitivity and specificity of T-SPOT.TB were 41.3% and 94.6%, respectively, both higher than TST (12.9% and 91.8%). By combining T-SPOT.TB and TST, the sensitivity did not increase, but specificity was elevated to 100%. TST, T-SPOT.TB and their combinations all performed better in patients with extra-pulmonary diseases than with pulmonary disorders. False-positive T-SPOT.TB results were found to be associated with history of prior TB. In addition, concomitant bacterial infections and low CD4 counts were associated with increased ATB risk.ConclusionsT-SPOT.TB is superior in screening ATB in HIV-infected patients in China over traditional TST. Additional TST would help to confirm a positive T-SPOT.TB result. Both tests work better for patients with extra-pulmonary conditions. |
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